Provider Demographics
NPI:1770817405
Name:CHOICE O&P, LLC
Entity Type:Organization
Organization Name:CHOICE O&P, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL
Authorized Official - Prefix:
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:ALTSHULER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:865-588-4256
Mailing Address - Street 1:314 ERIN DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37919-6209
Mailing Address - Country:US
Mailing Address - Phone:865-588-4256
Mailing Address - Fax:856-246-0080
Practice Address - Street 1:314 ERIN DR
Practice Address - Street 2:SUITE 101
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37919-6209
Practice Address - Country:US
Practice Address - Phone:865-588-4256
Practice Address - Fax:856-246-0080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-29
Last Update Date:2010-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN6400980001Medicare NSC